Tuesday, October 6, 2020
East Oregonian
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Medicare Advantage plans
from a new – but familiar –
face in Eastern Oregon
Local health providers create Summit Health insurance option
New to Medicare?
Here’s what you need to know
There’s no doubt about it, enrolling in Medicare
for the first time can be confusing. The important
signup dates, the different plans, what’s covered
and what’s not – it’s a lot to take in and figure
out. But with a little preparation and help from
experts, you can find a plan that will fit your
health care needs.
“For folks signing up for Medicare for the first
time, the process can seem a little overwhelming,”
said Walter Burkhartsmeier, director of Medicare
Programs at Summit Health. “But there are some
key things to know that will help make your first
experience with Medicare a good one.”
Burkhartsmeier shared his insights and more in
a short interview.
Who should sign up for Medicare?
Medicare is the federal health insurance program
for people who are 65 years of age or older. You
can learn more and sign up at ssa.gov.
When should you enroll?
You can sign up for Medicare three months
before your 65th birthday through three months
after. After you sign up the first time, there is
an Open Enrollment Period each year that runs
from October 15 through December 7. During
that time, people can sign up for Medicare,
Prescription Drug Plans or switch plans without
being penalized.
Where can people find Medicare plans?
Summit Health president Sean Jessup (pictured) helped create the Eastern Oregon Coordinated Care Organization
(EOCCO) with local hospitals in 2012. He worked with the same local partners to develop a new Medicare Advantage
health plan option available to East Oregonians in 2021. Open enrollment to sign up is Oct. 15 – Dec. 7.
There’s a new Medicare Advantage
provider in Eastern Oregon. But just
because it’s new doesn’t mean it’s not
familiar.
In fact, the new company, Summit Health,
is owned by a group of regional providers
who’ve been meeting the health care needs of
communities in Eastern Oregon for decades.
Summit, formed earlier this year, includes Good
Shepherd Health Care System, Grande Ronde
Hospital and Clinics, Saint Alphonsus Health
System, GOBHI, CHI St. Anthony Hospital,
Eastern Oregon IPA, Yakima Valley Farm
Workers Clinic and Moda. The Summit owners
and additional providers throughout Eastern
Oregon comprise a provider network that will
offer a full suite of health services
available in 2021.
“The name is new, but people in
Eastern Oregon already know who
we are,” said Sean Jessup, president
of Summit Health. “We are the same
hospitals, the same doctors who
have been taking care of people in
Eastern Oregon for years – the same
providers they have come to know
and trust.”
get high-quality care from providers they have
already built relationships with over the years.
Plans include Medicare Part A and Part B
benefits – also known as original Medicare – as
well as Part C (Medicare Advantage) and Part D
(Medicare Prescription Drug Coverage).
As a private insurer, Summit is able to offer
Medicare Advantage, which covers extra benefits
that Original Medicare does not, including vision,
hearing, dental and other health and wellness
programs.
“There’s no denying that the world of Medicare
can be a complex one,” Jessup said. “Our
experienced team is incredibly knowledgeable
and can help folks find their way to the right plan
and the right care they need based on the lives
they lead.”
“We are the same
hospitals, the same
doctors who have been
taking care of people
in Eastern Oregon
for years – the same
providers they have
come to know and
trust.”
Even before the creation of
Summit Health, all of the owners
had long been focused on meeting
the health care needs of the people
of Eastern Oregon.
“The founders originally got
together in 2012 to create the
Eastern
Oregon
Coordinated
Care Organization (EOCCO) to
help low income Oregonians,”
- Sean Jessup, president,
Jessup said. “With Summit, we’re
Summit specializes in Medicare
Summit Health
continuing our commitment to
Advantage plans for Eastern Oregon,
our community by providing
including Baker, Gilliam, Grant, Harney, Lake,
Medicare Advantage plans in partnership with
Malheur, Morrow, Sherman, Umatilla, Union,
local hospitals, doctors and other providers that
Wallowa and Wheeler counties.
folks in Eastern Oregon know and trust.”
The company’s Medicare Advantage plans,
available during the Oct. 15 to Dec. 7 open
enrollment period, are designed to help people
One of the best ways to find a quality Medicare
plan is to work with a local agent who knows
what plans would fit best with a person’s lifestyle.
You can go to medicare.gov and see all of the
plans available and how to learn more. All agents
offer free consultation to help walk you through
the benefits and sign-up process.
What are the most important things to look for
in a Medicare Advantage plan?
First, start by checking to see if your doctor,
hospital or clinic accepts the plan you choose.
Second, make sure your medications are covered
through your prescription drug plan, which
is known as Medicare Part D. Third, it’s really
important to make sure that your plan will
cover you if you decide to travel. For example,
plans through Summit Health have access to a
broad network of providers, so even if you travel
outside of Eastern Oregon, you can get care that’s
covered.
What else is key to a good Medicare Advantage
plan?
You want to pick a plan that provides total
wellness, which means a plan that includes the
coverage you need for the life you live. Dental
health is important for everyone, particularly
later in life. Make sure your plan includes dental
coverage that pays for more than just preventative
care, since restorative care becomes more
important for Medicare Advantage patients. If
you need hearing aids, look for a plan that will
help you pay for them; otherwise, out-of-pocket
expenses could be really high. And also look at
other specific benefits to fit your life and needs,
such as fitness programs, vision coverage, or
maybe you want help quitting smoking.
You can learn more about Medicare providers
and compare plans at medicare.gov.
You can learn more about Summit Health and
their plan benefits at yoursummithealth.com.
COVID-19 and a new year bring changes to Medicare
What’s changing with Medicare as the 2021 open enrollment season approaches
Some years, the changes to Medicare can be
significant. Last year, for example, some Medicare
plans added benefits to cover meal deliveries
and alternative pain treatments. The federal
government also revamped its Medicare.gov
website to make it easier for people to compare
plans.
“As far as changes to Medicare for 2021, we’re
not expecting things to be wildly different,” said
Harry Geller, president of St. Anthony Hospital.
“The COVID-19 pandemic has led to some
changes, and some drug prices could drop in
the coming year. There’s also a new Medicare
Advantage provider called Summit Health that’s
available in Eastern Oregon.”
More telehealth options available
Due to the pandemic, telehealth has become
a way to deliver care while keeping people out
of hospitals and medical clinics. Some plans
will increase their telehealth services and
coverage, including specialties like dermatology,
cardiology and behavioral health.
“I think telehealth is also really helpful when
it comes to letting beneficiaries know whether
they need to come into the clinic to get care or
when they can simply stay at home,” Geller said.
“That’s particularly helpful for people in Eastern
Oregon.”
More choices
One of the most visible differences for Eastern
Oregonians this year will be the presence of
Summit Health in the market. Created by a group
of regional providers who’ve been meeting the
health care needs of communities in Eastern
Oregon for decades, Summit launched in time
for the upcoming Medicare Open Enrollment
Period, which runs from Oct. 15 through Dec.
7. The company offers Medicare Advantage
plans that deliver care from providers who the
residents of Eastern Oregon have come to know
and trust over the years.
“We are new to the market but founded by local
hospitals and clinics, so we’ve really been here
taking care of East Oregonians all along,” said Sean
Jessup, president of Summit Health. “We’ll be able
to help people navigate these changes to Medicare
Advantage while finding the right kind of plan that
will work for them and the lives they lead.”
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